AUSTIN, Texas — The state of Texas cannot intervene in a lawsuit between Children’s Medical Center Dallas and one of its doctors over gender-affirming care for trans patients, a Dallas judge decided Friday.
After a contentious hearing that lasted more than two hours, Dallas County Judge Melissa Bellan said Attorney General Ken Paxton had not convinced her that the state had an interest in this case. Paxton’s office is expected to fight her decision at the 5th Court of Appeals in Dallas.
Bellan’s decision marks another win for Dr. Ximena Lopez, who sued Children’s to reverse its recent decision to stop providing certain treatments like puberty blockers and hormone therapy to new transgender patients.
Last month, Children’s agreed to allow Lopez to resume this care through April 2023 while the case is being litigated. Bellan’s decision will allow her to continue seeing patients under this agreement, according to her lawyers, who accused Paxton of targeting trans care for “purely political reasons.”
“We are pleased that Judge Bellan saw through these shenanigans and struck the intervention. It is mind boggling that Paxton continues to fight against the best interest of children,” Charla Aldous, one of Lope’s lawyers, said in a statement.
In Friday’s hearing, Paxton deputies said the state opposed the agreement between Children’s and Lopez on the grounds that his office believes these treatments can constitute child abuse.
“That decision goes against child welfare laws as we interpret them,” Assistant Attorney General Johnathan Stone told Bellan. “We’re defending the state’s ability to enforce the law.”
Stone pointed to a nonbinding opinion Paxton issued in February that came to the conclusion that these treatments are considered child abuse under current law. The state, under Gov. Greg Abbott’s blessing, has cited this opinion to investigate families with transgender children.
But Brent Walker, one of Lopez’s attorneys, pointed out that there is no state law explicitly defining gender-affirming medical treatments like these as abuse. State lawmakers declined to pass a bill doing so in 2019.
Last month, the Texas Supreme Court ruled that Paxton and Abbott had no authority to force such abuse investigations. Bellan cited this ruling repeatedly when questioning the state as to why they thought they could intervene in this case.
“That opinion is not legally binding. So that shoots your argument out of the water,” Bellan told Stone. “The Texas Supreme Court said the AG’s opinion is not binding, it is not law and that the AG should not be getting involved in these situations.”
The judge noted that the agreement between Lopez and Children’s only allowed the doctor to approve minors for gender-affirming medical treatments according to her best medical judgment and within the standards of care.
Stone attempted to sway her thinking by noting that the state, if allowed to intervene, would show there are disagreements in the medical community over transgender medicine.
Bellan declined, noting the state could not cite an abuse allegation or other specific reason to intervene in this case. She also said Children’s, which is the defendant in this case, did not ask for the state to intervene.
Children’s lawyers did not speak during Friday’s hearing. A spokeswoman declined to comment on the state’s request to intervene earlier this week, citing the ongoing litigation.
Lopez’s legal fight dates back to November, when Children’s and UT Southwestern decided remove the branding for its program for transgender youth, called Genecis, and halt certain treatments for new underage trans patients. The hospitals defended the changes, first saying they were made to provide more patient privacy and later citing political and scientific controversy.
Friday’s hearing grew heated at times. Bellan chided the state for arguing points that had already been decided by the court, and Walker repeatedly compared Paxton’s actions to those who sought to derail the election certification process in Washington on Jan. 6, 2020.
“This is just about an attorney general who wants to be a roving warrior on behalf of his own interests,” Walker said, later adding, “You have people who are exceeding their legal authority and the courts are guardrails against this."
Stephen Malouf, another attorney for Lopez, added that the state argued in its most recent brief that it was child abuse to provide these treatments to prepubescent children. Malouf called that argument disingenuous because standards of care already dictate that children who have not reached puberty should not receive puberty blockers or hormone therapy.
Age appropriate and individualized medical treatments for transgender youth are supported by the state and nation’s largest physicians groups, including the American and Texas Medical Associations. They have opposed halting or altering care due to political pressure.
“It’s absurd and it’s time to call these people out. You know we all respect the office of attorney general but not every attorney general fills that office,” Malouf said. “Cruelty and kindness has become vogue.”
Both blamed Paxton’s actions on election year antics. Assistant Attorney General Courtney Corbello, early in the hearing, said the state’s intervention was sound.
“We have an entirely good faith basis and a reasonable basis to intervene,” she said.
Abbott and Paxton are both up for reelection this year. In addition to this case, the governor’s order to investigate families with transgender children is also being litigated. Another judge has recently put several of those investigations on hold earlier this month.
The Legislature meets next in January 2023.
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